HBsAg携带孕妇外周血中IL-2和IL-10水平与HBV宫内传播的关系  

The relationship between the expression of IL-2 and IL-10 in the peripheral blood of HBsAg carrier pregnant women and HBV intrauterine transmission

作　　者：颜晓玥 马偲航 候文婷 温乐基 张磊 YAN Xiaoyue;MA Sihang;HOU Wenting;WEN Leji;ZHANG Lei(Xiamen University,School of Public Health,Xiamen 361102,China;Department of Science and Education,Longyan First Hospital,Longyan 364000,China;Laboratory Department,Longyan First Hospital,Longyan 364000,China)

机构地区：[1]厦门大学公共卫生学院,厦门361102 [2]龙岩市第一医院科教科,龙岩364000 [3]龙岩市第一医院检验科,龙岩364000

出　　处：《中华疾病控制杂志》2025年第1期111-116,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81102140,81472988)。

摘　　要：目的 探讨乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性孕妇外周血中白细胞介素(interleukin,IL)-2和IL-10水平在乙型肝炎病毒(hepatitis B virus,HBV)宫内传播中的表达变化,研究影响其分泌水平的因素及二者对HBV宫内传播的预测价值。方法 对2015―2017年纳入的陕西省西北妇女儿童医院经产前筛查的327例HBsAg阳性孕妇进行流行病学调查,采用酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)法检测孕妇和新生儿外周血乙肝五项,采用实时荧光定量聚合酶链式反应(polymerase chain reaction,PCR)检测HBV-DNA水平,采用流式液相芯片法检测IL-2和IL-10水平。采用二元logistic回归分析模型进行多因素分析,使用受试者工作特征(receiver operating characteristic,ROC)曲线分析IL-2和IL-10预测传播结局的价值。结果 HBsAg阳性孕妇宫内显性传播(dominant hepatitis B virus transmission,DBT)、宫内隐匿性传播(occult hepatitis B virus transmission,OBT)和宫内传播发生率分别为10.40%(34/327)、15.29%(50/327)、25.69%(84/327)。HBV宫内未传播(non-intrauterine transmission,NBIT)组和OBT组之间的IL-10表达水平存在差异(Z=-2.054,P=0.040)。乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阳性孕妇外周血中的IL-10水平高于HBeAg阴性孕妇(U=8 355.000,P=0.007),且IL-10水平随着孕妇外周血中HBV-DNA载量的增加而升高。相较于OBT发生风险,HBeAg阳性孕妇DBT发生风险更大(P<0.001)。ROC曲线结果显示,IL-2在HBV-DNA水平为10^(3)~10^(6) IU/mL时,预测HBV宫内传播的曲线下面积(area under curve,AUC)为0.676(95%CI:0.534~0.819,P<0.05);IL-10在HBV-DNA水平小于10^(3) IU/mL时,预测HBV宫内传播的AUC为0.626(95%CI:0.537~0.715,P<0.05)。结论 HBsAg携带孕妇外周血中的IL-2和IL-10水平增加,尤其IL-10的水平在NBIT组中随孕妇HBeAg阳性、HBV-DNA载量升高而增加,可考虑作为HBV OBT早期预测的指标,为乙肝高危婴儿的免疫检测提供依据。Objective To investigate the expression changes,influencing factors and predictive value of hepatitis B surface antigen(HBsAg)-positive maternal peripheral blood interleukin(IL)-2 and IL-10 levels in hepatitis B virus(HBV) intrauterine transmission.Methods An epidemiologic survey was conducted on 327 HBsAg-positive mothers who delivered at Northwest Women′s and Children′s Hospital in Shaanxi Province in 2015-2017.The levels of cytokines interleukin-2 and interleukin-10 were detected by enzyme-linked immunosorbent assay for the five hepatitis B items in the peripheral blood of pregnant women and newborns.Real-time fluorescence quantitative PCR was used for the levels of HBV-DNA,and flow-liquid microarray for the levels of cytokines IL-2 and IL-10.Multifactorial analyses were performed using a binary logistic regression analysis model,and the value of IL-2 and IL-10 in predicting transmission outcomes was analyzed using the receiver operating characteristic curve.Results The rates of dominant HBV transmission(DBT),occult hepatitis B virus transmission(OBT) and intrauterine transmission were 10.40%(34/327),15.29%(50/327) and 25.69%(84/327),respectively.There was a significant difference in IL-10 expression between NBIT group and OBT group(Z=-2.054,P=0.040).The level of IL-10 in hepatitis B e antigen positive pregnant women was significantly higher than that in HBeAg negative pregnant women(U=8 355.000,P=0.007).Besides,the expression level of IL-10 increases with the the increase of DNA load.HBeAg-positive pregnant women were at greater risk of DBT than OBT(P<0.001).The results of the receiver operating characteristic curve showed that IL-2 had an area under curve of 0.676 for predicting intrauterine transmission of HBV at HBV-DNA levels of 10^(3)-10^(6) IU/mL(95% CI:0.534-0.819,P<0.05) and IL-10 had an AUC of 0.626 for predicting intrauterine transmission of HBV at HBV-DNA levels < 10^(3) IU/mL(95% CI:0.537-0.715,P<0.05).Conclusions The expression of IL-2 and IL-10 are increased in HBsAg carrier pregnant women,e

关 键 词：乙型肝炎病毒 宫内传播 白细胞介素-2 白细胞介素-10 

分 类 号：R181.2[医药卫生—流行病学]